Neck Pain After Cerebral Angiogram

First of all, I want to send a BIG "THANK  YOU" to the doctors who so graciously provide us with answers to our many questions.  You're certainly appreciated!

Here's my question.  I had a cerebral angiogram in August that showed abnormally small arteries/vessels in the back of the head.  Drs. opinion is that this finding is consistent with someone with migraine.  To-date, I've been diagnosed as "complicated migraine".  I get pretty severe neuro deficits when the episodes come.  About a month later and to this date, I developed pain in the right side of my neck.  I mentioned it to my internist, he said it's probably an inflammation and to take Advil and he didn't feel a neck study was warranted.  Well, it been quite a long time and the pain is continuing, sometimes pretty severe behind the ear at the base of the skull.  I'll be seeing my Internist again this coming Monday and I'm going to insist on having a study done.  What should I ask for?  Do you think the angiogram could have the area inflammed?  Do you think the neck pain is simply a manifestation of the migraine?  Your opinions are most welcome!

[CCF-Neuro-M.D.-JT]

It's extremely difficult to comment on an angiogram that I haven't personally reviewed. But "small arteries" don't necessarily mean migraine. It can represent a number of things such as vasculitis or Moya-Moya syndrome, a condition of small occluded vessels that are branches of the main brain arteries leading to little strokes.  To comment on your neck pain, I would consider seeing a neurologist to get a formal exam especially because your angiogram wasn't completely normal. This could certainly represent migraine, but if there is anything abnormal that points to a stroke I would be concerned about a possible tear in the artery in your neck. To evaluate this you would need an MRI of the neck arteries with fat saturation ( your neuro will know what that means).  Talk to your doc about getting a neuro referral. That will get you started in the right direction. Best of luck.